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  • Scott Adams
    Scott Adams

    One Blood Test Can Now Diagnose Celiac Disease without Biopsy

    Reviewed and edited by a celiac disease expert.

    An upcoming report by British researchers for the leading gastroenterology journal Gut, shows that the blood test alone is 95 per cent accurate for diagnosing celiac disease.

    One Blood Test Can Now Diagnose Celiac Disease without Biopsy - Image: CC BY 2.0-- UC Davis College of Engineering
    Caption: Image: CC BY 2.0-- UC Davis College of Engineering

    Celiac.com 09/24/2020 - Celiac disease is an autoimmune condition in which eating wheat, rye, or barley triggers an adverse immune reaction in the gut. Celiac disease affects about one percent of the population. Diagnosis can be a long and arduous process. In the United States, the average person with celiac disease can wait up to ten years from the time of first symptoms to diagnosis. Left undiagnosed, autoimmune disease can cause organ damage and bowel cancer.

    Anyone who has ever had to suffer through a long, convoluted process to get their celiac disease diagnosis can now rejoice for any new celiacs going forward. That's because researchers have developed a single blood test that can diagnose celiac disease without biopsy. Until now, the "gold standard" for celiac diagnosis was the duodenal biopsy, which is normally performed by a gastroenterologist in the days or weeks after a positive blood test, during which time the patient needs to keep consuming gluten. However, nearly half of patients did not need to undergo a more risky biopsy procedure at all.

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    This data, coupled with the need to catch up with a backlog of endoscopies created during the Covid-19 pandemic, has provoked a change in guidance from the British Society of Gastroenterology and The National Institute for Health and Care Excellence (NICE). An upcoming report by British researchers for the leading gastroenterology journal Gut, shows that the standard tTG blood test alone is 95 percent accurate for diagnosing celiac disease.

    Trials show the tTG blood test to be 95 percent sensitive (meaning it detects celiac disease 95 times out of 100), and 95 percent specific (meaning it gives a false positive result just 5 times out of 100). The test measures blood levels of anti-transglutaminase antibodies, or tTG2, which are higher in people with celiac disease. 

    TTG2 proteins are among the proteins trigger the immune reaction the causes inflammation when celiac eat wheat, rye, or barley. Celiacs have hundreds times more tTG proteins than non-celiacs.

    Being able to diagnose celiac disease quickly and accurately, via blood test alone, is a huge game-changer for celiac patients. Tens of thousands of people with suspected celiac disease can now get a diagnosis with a simple blood test, sparing them from the more risky biopsy procedure.

    Not only will many be spared the prolonged side-effects, and invasive, drawn-out diagnosis, they will also be spared the long-term damage that come with undiagnosed celiac disease.

    Read more at DailyMailnews-medical.net, and bmj.com.

    Edited by Scott Adams



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    Guest ANTHONY COLATRELLA

    Posted

    Am I missing something here?----there is nothing new here at all----this is the same TTg-antibody test that has been used to diagnose celiac disease for the last several years with the same known sensitivity and specificity---this is no new discovery or information at all---the AGA has been aware of these data and still recommends a small bowel biopsy to confirm diagnosis. It just looks like because of the large backlog of endoscopy due to the pandemic on top of their already backed up procedural schedules because of their medical system, they have essentially been forced to "modify" their criteria for diagnosing celiac disease and simply omitting the already long delayed endoscopy---and essentially adopting the same criteria they use for the pediatric patient----the >10x the upper limit of normal---as the threshold for diagnosis----although it is not specifically mentioned in the summary, I wonder if the other criteria must be present as well---i.e.---positive symptoms, positive EMA, and compatible genotype.  the AGA does not recognize the British pediatric criteria as yet and I am sure will not adopt this modified criterion either---not without more follow-up data. 

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    Guest ANTHONY COLATRELLA

    Posted

    On 9/28/2020 at 8:39 PM, cyclinglady said:

    There is no special celiac antibodies test — just the usual ones offered.  The article just states that if your celiac antibody results are very high, you can probably skip the endoscopy.  Ask your doctor to get tested.  

    This is nothing new---this is exactly the same test that has been used to diagnose celiac disease for the last 10years---it seems to me the British have decided because their endoscopy schedules(already long delayed due to their medical system) are now because of Covid-19 probably so far back-logged they are just going to do without the endoscopy and feel the data is adequate to support their decision---they had already done this with their pediatric patients.

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    Guest ANTHONY COLATRELLA

    Posted

    On 9/28/2020 at 4:56 PM, Guest Kansas said:

    Okay, but how do I get this blood test?? Is it available in the US yet?

    This is the standard test used in the US to diagnose celiac disease for the last 10 years-nothing new, nothing different---apparently the British GI-endoscopy schedules have been overwhelmed by Covid-19 and they have decided to take a bit of a "short-cut" for diagnosis and apparently feel their data justifies this---unlikely the US will feel the same way---at least not until more data is available.

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    Guest ANTHONY COLATRELLA

    Posted

    This is a VERY DECEIVING headline---if you actually read the entire summary in the DAILY MAIL you will clearly see this is just "A TEMPORARY" maneuver by the British GI society in attempt to help take some pressure off an overwhelmed endoscopy system due to the pandemic---they are simply just going to rely on a markedly elevated TTg to diagnose celiac disease and forego the endoscopy---FOR NOW---presumably until their endoscopy schedules "catch up"---whenever that will be---their endoscopy schedules are normally backed up because of their medical system--even without the pandemic.  At that time they will review the data and decide how to proceed.  This is the same TTg test that has been used for the last 10 tears or more to diagnose celiac disease---it is not a new or different test! I think the pandemic has essentially forced them to take a "little short-cut" here!  Do not look for this to happen in the US in the near future 

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    Guest ANTHONY COLATRELLA

    Posted

    Scott, I think you could have done a much better job in editorializing this article---the title of the article is entirely deceptive----to borrow a political term---this is "fake news'----obviously there is nothing new about the TTG, and as you read the summary in the linked DAILY MAIL it is clear that this is, as is stated, "a temporary" measure forced by the back-log of endoscopy due to Covid-19   To say that " researchers have developed a single blood test to diagnose celiac disease without a biopsy" is clearly misleading -in regard to the TTg which has been the recommended blood test for celiac disease for at least 10 years--in conjunction with a small bowel biopsy--- and to term this "a game changer" is just wrong---even the authors of the article raise questions about it and after admitting it is just a temporary measure say the data will need to be reviewed in the future---i.e. if and when their endoscopy schedules return to a "new" normal! This is a British policy change ONLY and will not impact any other celiac patients at this time---I think you could have made this much clearer---certainly if you look at the questions

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    cyclinglady
    12 hours ago, Guest Happy camper said:

    Are celiacs at more risk if they contract COVID?

    Diagnosed and treated celiac disease patients are at no greater risk than the general population.  There are exceptions.  For example, if you have celiac disease and are 80 years old, you may be at greater risk of dying from COVID.    

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    cyclinglady
    On 9/29/2020 at 12:12 AM, sc'Que? said:

    Will it still work if you are already following a strict gluten-free diet?  

    All celiac disease testing requires you to be on a full gluten diet.  

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    cyclinglady
    12 hours ago, Guest Happy camper said:

    I have silent celiac, which makes it harder to not eat gluten. Wondering how bad is it to still eat some gluten, should I be worried?

    Yes, you should be worried.  Even if asymptomatic, consuming gluten will damage your gut.  Ask your doctor for follow-up testing to determine if you are adhering to the diet.  

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    Guest ANTHONY COLATRELLA

    Posted

    On 9/30/2020 at 3:50 PM, cyclinglady said:

    Yes, you should be worried.  Even if asymptomatic, consuming gluten will damage your gut.  Ask your doctor for follow-up testing to determine if you are adhering to the diet.  

    Cycling Lady, based on your questions you do not seem to have a good understanding of Celiac disease; I hope you have a gastroenterologist to whom you can refer your questions---if not you should!

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    notme
    1 hour ago, Guest ANTHONY COLATRELLA said:

    Cycling Lady, based on your questions you do not seem to have a good understanding of Celiac disease; I hope you have a gastroenterologist to whom you can refer your questions---if not you should!

    what questions are you referring to and are attributing to cyclinglady?  

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    Guest ANTHONY COLATRELLA

    Posted

    On 10/2/2020 at 5:08 PM, notme! said:

    what questions are you referring to and are attributing to cyclinglady?  

    Sorry, my mistake---hard to determine who is asking what question!

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    Scott Adams
    On 9/24/2020 at 4:11 PM, cyclinglady said:

    Ah, but....

    ”Those with antibody levels lower than ten times the normal range will still require an endoscopy before the diagnosis can be confirmed.”

    An endoscopy is still valuable per the referenced article.  
     

    A biopsy would still be needed for 5% of people per the article, and the standard tTG test is 95% accurate in diagnosing celiac disease--thus 95% of people can avoid biopsy. That is a great thing! Who wants to undergo a risky procedure that could give them an infection or subject them to a risk from the anesthesia?

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  • About Me

    Scott Adams

    Scott Adams was diagnosed with celiac disease in 1994, and, due to the nearly total lack of information available at that time, was forced to become an expert on the disease in order to recover. In 1995 he launched the site that later became Celiac.com to help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives.  He is co-author of the book Cereal Killers, and founder and publisher of the (formerly paper) newsletter Journal of Gluten Sensitivity. In 1998 he founded The Gluten-Free Mall which he sold in 2014. Celiac.com does not sell any products, and is 100% advertiser supported.


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